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Items 1 to 100 of about 157

1. Tang LH: Epithelial neoplasms of the appendix.Arch Pathol Lab Med; 2010 Nov;134(11):1612-20[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Epithelial neoplasms of the appendix.

CONTEXT: The appendix gives rise to an array of epithelial neoplasms showing glandular or neuroendocrine differentiation, and some tumors with elements of both cell types.

Although some appendiceal neoplasms resemble their counterparts in the small and large intestines (conventional adenocarcinoma and carcinoidtumor), the appendix also gives rise to relatively unique entities including mucinous neoplasms and goblet cell carcinoidtumors, which present a challenge in pathologic classification and clinical management.

OBJECTIVE: To review clinical and diagnostic issues for 3 pathologic types of epithelial neoplasms of the appendix:.

DISCUSSION: Cutaneous metastasis of colorectal cancer is an uncommon event that usually occurs after identification of the primary tumour and generally indicates advanced-stage disease and an ominous prognosis.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Carcinoidtumors of the appendix: when right colectomy?].

Three cases of carcinoidtumour of the appendix (about 0,3 % of all performed appendectomies) has induced the Authors to a review of the literature with the aim to underline the most important biological and pathological findings and the current clinic and therapeutic knowledges.

The kind of surgical intervention, that is the entity of the surgical demolition, for the treatment of the carcinoidtumours of the appendix is still controversial: appendectomy or right colectomy?

It is possible identify, also during the operation for an appendicitis or for other abdominal lesions, criteria that can orient toward a major surgery (size of the neoplasia, subserosal lymphatic invasion, infiltration of the serosa, diffusion in the meso-appendix, location in closeness of the base of the appendix, invasion of the the locoregional lymph nodes, presence of metastases, section ?margins, number of mitoses, cellular pleiomorfism).

The results were subjected to a stepwise linear discriminant analysis.

Goblet cell carcinoids were significantly different from the control groups.

The most important markers for discriminating between the groups were CEA (classical carcinoid versus all others), KRas mutation (present in all mucinous cystadeno (carcino)mas), beta-catenin (goblet cell carcinoid versus left sided colonic adenocarcinoma) and chromogranin (goblet cell carcinoid versus right sided colonic adenocarcinoma).

Expression of Math1 and HD5 was similar in goblet cell carcinoid and colonic adenocarcinoma but absent in classical carcinoid.

CONCLUSION: The results suggest that goblet cell carcinoids should be regarded as a separate entity.

The formerly used term 'crypt cell carcinoma' may be more appropriate because it reflects the more aggressive clinical behaviour of these tumours as well as their greater similarity to adenocarcinomas rather than to carcinoids.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The so-called clear cell change has been described in neuroendocrine tumors at several locations.

Those associated with von Hippel Lindau disease are pathognomonically "clear" and the cytoplasmic appearance has been ascribed to intracytoplasmic lipid.

However, lipid has not been demonstrated in all cases of clear cell carcinoidtumors.

Such variants have not been described in carcinoidtumors of the appendix and cases with a prominent proportion of clear or more correctly, lipid-rich cytoplasm may bear a superficial resemblance to goblet cell carcinoid and/or signet ring adenocarcinoma.

Seven cases, in 5 females and 2 males ranging in age from 22 to 65 years, were noted to have a population of lipid-rich and vacuolated clear cells accounting for 25% or more of the tumor population.

The carcinoidtumors were incidental in all cases with 4 of patients presenting with appendicitis, 2 with concomitant mucinous cystadenocarcinomas of the appendix and 1 with an adenocarcinoma of the ascending colon.

Morphologically, the tumors had a nested and trabecular pattern and were composed of an admixture of microvesicular and clear lipid-rich cells.

None of the patients have shown evidence of recurrent disease.

The importance of recognizing this variant of carcinoidtumor in the appendix is to avoid confusion with goblet cell carcinoidtumors with or without a signet ring adenocarcinoma.

The presence of multi-vacuolated, foamy and clear cells, some resembling signet ring or goblet cells, in otherwise classic carcinoidtumors is rare but should be considered in this context in the appendix.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: Several studies reported that pathology of the appendix is frequently detected alongside endometriosis, especially with chronic pelvic pain.

Furthermore, ovarian endometriosis is a marker of more extensive pelvic and intestinal disease.

METHODS: One hundred and six women with ovarian endometrioma underwent laparoscopic surgery including laparoscopic appendectomy.

RESULTS: The main symptoms consisted of lower abdominal pain in 51 (48.1%) women, dysmenorrhoea in 23 (21.7%), left lower quadrant pain in 6 (5.7%), right lower quadrant pain in nine (8.5%), chronic pelvic pain in five (4.7%), and others in 12 (11.3%).

Only three (3.3%) of the 106 women had abnormal findings on gross inspection during laparoscopic surgery: two women with endometriotic spots on the surface of their appendixes, and one with peri-appendiceal inflammation with severe adhesions.

Of the 106 resected appendixes, 37 (34.9%) had histopathologically confirmed pathology including lymphoid hyperplasia in 12 (11.3%), endometriosis in 14 (13.2%), peri-appendicitis and serositis in five (4.7%), carcinoidtumour in three (2.8%), and others in three (2.8%).

CONCLUSIONS: In all surgical treatments for ovarian endometrioma, surgeons need to preoperatively inform the patients of the fact that appendiceal pathology including endometriosis is found frequently regardless of concurrent symptoms or gross finding of the appendix.

Furthermore, surgeons should take into account the possibility of appendiceal pathology during operation.

RESULTS: Sixteen patients were diagnosed with goblet cell carcinoid between 1995 and 2005.

Patients were divided into two groups: those where the diagnosis was an incidental finding at operation (Group 1) and those where the presentation was of an abdominal mass or metastatic disease (Group 2).

We report a rare combination of these tumours and discuss the latest treatment options.

Laparoscopy revealed an adenocarcinoid of the appendix in combination with mucinous cystadenoma.

Most tumours are less than 2 cm in diameter and 20% of them metastasize to the ovaries.

Right hemicolectomy is generally advised if any of the following features are present: tumours greater than 2 cm, involvement of resection margins, greater than 2 mitoses/10 high-power fields on histology, extension of tumour beyond serosa.

Chemotherapy mostly with 5-Fluorouracil and Leucovorin is advised for remnant disease after surgery.

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(PMID = 19171048.001).

[ISSN] 1752-1947

[Journal-full-title] Journal of medical case reports

[ISO-abbreviation] J Med Case Rep

[Language] eng

[Publication-type] Journal Article

[Publication-country] England

[Other-IDs] NLM/ PMC2647933

11. Wang HL, Dhall D: Goblet or signet ring cells: that is the question.Adv Anat Pathol; 2009 Jul;16(4):247-54[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Goblet cell carcinoidtumor is a rare mixed endocrine-exocrine neoplasm of the appendix.

It carries an intermediate biologic behavior between a classic carcinoidtumor and a conventional adenocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoid of the vermiform appendix. Description of three clinical cases and review of the literature.

[Transliterated title]Carcinoide dell'appendice vermiforme.

Carcinoids of the appendix represent a separate class of tumours with characteristics that vary between benign (adenomas) and malignant (carcinomas) neoplasias.

A recent nomenclature identifies them as diffuse neuroendocrine system (DNS) and/or, parallely, as neuroendocrine tumours (NET): the gastroenteric tract is the site of about 64.3% of carcinoids, followed by the respiratory tract with 25.3%.

Among the gastrointestinals, tumour of the small intestine is the one with the highest incidence with 28.5%, followed by the appendix with 4.77%, the rectum with 13.6% and the stomach with 4.6%.

Carcinoid of the colon has an incidence of 8.62%, with the caecum which alone represents 34.5% of colic localisations.

The 3 cases described are an example of the behavioural unpredictability of intestinal carcinoids.

The first case is that of a female patient in whom the primary tumour was only discovered after liver metastasis was documented.

Subsequent investigations carried out in the postoperative period documented the presence of liver metastasis at the V and VI liver segments.

The last case, similar to the second from certain points of view, shows the need to carry out a right hemicolectomy with removal of locoregional lymphnodes in the event of an appendicular carcinoid >2 cm.

Both laboratory and instrumental examinations contribute to the diagnosis of intestinal carcinoid.

First level instrumental examinations for the diagnosis of intestinal carcinoid are represented by CT with and without contrast medium, diagnostic endoscopy and, to better highlight the presence of locoregional metastases, scintigraphy with octreotide and PET.

Treatment with somatostatin, on the other hand, proved effective in controlling tumour secretion, so attenuating the inconveniences of carcinoidsyndrome.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Results of emergency appendectomy for appendicular mass.

Emergency appendectomy was done on 1142 patients during the period of July 1990 to January 2003 to evaluate the results.

342(30%) patients had appendix abscess and 228(19.96%) had loculated collection.

All had appendicitis except two of which one patient had carcinoidtumor and one had enteric fever perforation.

It seems that emergency appendectomy could safely be done in appendix mass without any increased risk of mortality and morbidity.

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(PMID = 17703161.001).

[ISSN] 1022-4742

[Journal-full-title] Mymensingh medical journal : MMJ

[ISO-abbreviation] Mymensingh Med J

[Language] ENG

[Publication-type] Journal Article

[Publication-country] Bangladesh

16. Azordegan N, Yazdankhah A, Moghadasian MH: A rare case of coexistence of carcinoid tumor of appendix vermicularis and ileal endometriosis.Arch Gynecol Obstet; 2009 Feb;279(2):183-7[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] A rare case of coexistence of carcinoidtumor ofappendix vermicularis and ileal endometriosis.

BACKGROUND: Carcinoidtumor is the most common tumor ofappendix with overall good prognosis.

CASE REPORT: We here report the coexistence of carcinoidtumor ofappendix and ileal endometriosis in a 37-year-old nulliparous woman who came to the emergency room with right lower abdominal pain mimicking acute appendicitis.

The main clinical and laboratory findings included fever, leukocytosis and elevated ESR.

With preoperative suspicion of acute appendicitis, laparatomy was performed and revealed apparently normal looking appendix, along with a nodule in the terminal ileum.

The tumors had penetrated the muscularis propria in all resected cases.

Four (17.4%) patients had a second non-carcinoid primary tumor.

CONCLUSIONS: Carcinoidtumors of the colon are frequently right-sided and may be clinically occult until an advanced stage is reached.

Based on the relatively poor survival rates reported, it is recommended that, in addition to standard surgical resection, vigorous surveillance for metastatic disease must be performed, particularly during the first 2 years after surgery.

In addition, these patients require evaluation of the entire gastrointestinal tract for evidence of coexisting malignancy, along with an extended period of follow-up, because tumor recurrences after 5 years are not uncommon.

DATA SOURCES: A review of the recent literature including TNM classifications and patient management guidelines.

Evaluation of their prognoses and risks of malignancy, according to these classifications, depends on several parameters including tumor size, proliferation rate, and infiltration of appendiceal wall and mesoappendix.

Most patients with classic endocrine tumors of the appendix have a favorable prognosis.

Indications for postappendectomy, complementary surgery, which are still controversial, especially for tumors between 1 and 2 cm, are presented and discussed.

In contrast, in patients presenting with a goblet cell carcinoid, a right hemicolectomy after the initial appendectomy is considered the standard surgical intervention.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Unanticipated findings at bariatric surgery.

In only three cases (one case each of carcinoid of the appendix, Sertoli-Leydig cell tumor of the ovary, and serous cystadenocarcinoma of the ovary) would there have been a significant difference in the patient's prognosis had the problem been left undiagnosed.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoidtumors of the appendix: are these tumors identifiable prospectively on preoperative CT?

The purpose of this study was to determine if carcinoidtumors of the appendix were identified prospectively on preoperative CT at our institution during the last decade.

A surgical database search performed using the Current Procedural Terminology codes for appendectomy and colectomy yielded 2108 patients who underwent appendectomy or colectomy with removal of the appendix from January 1998 through September 2007.

Pathology reports were reviewed to identify patients in whom an appendicealcarcinoidtumor was identified.

Twenty-three carcinoidtumors (1.1%; 15 women [65.2%], eight men [34.8%]; average age 54 years [range, 23 to 86 years]) were identified.

No tumors were identified prospectively on CT.

Average reported tumor size was 6.1 mm (range, 1.5 to 15 mm; n = 18).

A tip or distal location was reported for all tumors for which a location was given (n = 15).

Carcinoidtumors occurred in 1.1 per cent of appendix specimens.

These tumors were all less than or 1.5 cm in size.

Likely as a result of their small size, none of these tumors was identified prospectively on preoperative CT.

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(PMID = 20349655.001).

[ISSN] 0003-1348

[Journal-full-title] The American surgeon

[ISO-abbreviation] Am Surg

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

26. Krysiak R, Okopień B, Herman ZS: [Current concepts on diagnosis and treatment of carcinoid].Przegl Lek; 2007;64(2):103-10[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Current concepts on diagnosis and treatment of carcinoid].

Carcinoidtumours are relatively rare neuroendocrine neoplasms that often present as diagnostic dilemmas due to obscure or non-specific symptomatology.

Carcinoids occur most frequently in the gastrointestinal system, where they are most common in the small intestine, appendix, and rectum, and in the bronchi.

Although, the majority are nonfunctional, some carcinoids can cause so called classical or atypical carcinoidsyndrome and sometimes also paraneoplastic syndromes.

Carcinoidtumours often present with metastatic disease.

Recent years have brought new developments in the field of their diagnostic and treatment options.

Despite the fact that many advances have been made in both the basic science and clinical areas, the optimal treatment of carcinoidtumours is still a matter of debate.

In this article, the pathogenesis, clinical aspects, classification, diagnosis and treatment of carcinoids are reviewed including the latest advances in each area.

With regard to patient demographics, carcinoids presented at an earlier mean age of 41 years and 71 percent were female (P < 0.001 for both).

Although current guidelines specify that a right hemicolectomy (rather than an appendectomy) be performed for all noncarcinoid tumors andcarcinoidtumors >2 cm, we found that 30 percent of noncarcinoids underwent appendectomy.

Similarly, 28 percent of carcinoids >2 cm under-went appendectomy, which is a lesser resection than is indicated.

CONCLUSIONS: This study provides a population-based analysis of epidemiology, tumor characteristics, survival, and quality of care for appendiceal carcinomas.

This characterization provides a novel description of the presentation and outcomes for malignancies of the appendix and highlights that a substantial number of patients with appendiceal tumors may not be receiving appropriate surgical resection.

Scintigraphy with (111)In-DTPA-d-Phe(1)-octreotide has led to an importance advance in the diagnosis of extension in carcinoidtumor patients.

CLINICAL CASES: The first patient (9 years) was studied using the SSRS after surgery due to carcinoidtumor in the right lower lobe in which tumor remains was observed (this being clearer in the tomography study).

The second patient (10 years) presented due to endobronchial tumor in the left lower lobe together with atelectasis of the LUL and emphysema of the LLL.

The SSRS showed an abnormal deposit of activity in the left hemithorax consisted with carcinoidtumor.

After the surgery (endobronchial resection), new controls with SSRS showed absence of disease.

The third patient (12 years) came after a lobectomy (RUL) due to bronchial carcinoid.

In the subsequent control (3 months), a deposit of activity was observed in the middle third of the right hemithorax, after which a lobectomy was performed (RLL and ML) that showed small remains of neuroendocrinecarcinoid.

CONCLUSION: The SSRS has demonstrated great utility in the diagnosis, follow-up and staging of pediatric patients, carriers of neuroendocrinecarcinoidtumors.

[Journal-full-title] Journal of pediatric surgery

[ISO-abbreviation] J. Pediatr. Surg.

[Language] eng

[Publication-country] United States

35. Maes M, Segers K, Cheyns P: Goblet cell carcinoid of the appendix: laparoscopic appendectomy or right hemicolectomy?Acta Chir Belg; 2008 Jul-Aug;108(4):447-50[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Goblet cell carcinoid of the appendix: laparoscopic appendectomy or right hemicolectomy?

Goblet cell carcinoids are uncommon tumours with histological features of both adenocarcinoma and carcinoidtumour.

They occur predominantly in the appendix and although the malignant potential remains unclear, adenocarcinoids appear to be more aggressive than conventional carcinoids.

In this case report, we present a goblet cell carcinoid with laparoscopic operative treatment in two stages.

Macroscopically, a diffusely inflamed appendix was found with no sign of perforation.

Histopathological examination revealed a goblet cell carcinoid with characteristics of aggressive behaviour, indicating the need for laparoscopic right hemicolectomy in which, however, neither residual tumour nor metastatic lymph nodes could be found.

As they may present the same clinical presentation, pathological diagnosis is required to distinguish goblet cell carcinoid from acute appendicitis.

Two-stage surgery for goblet cell carcinoid is advocated in the literature, but the debate still continues as to whether the goblet cell carcinoid should be treated by appendectomy alone, as for most carcinoids, or by right hemicolectomy, as for the appendiceal adenocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoidtumors of the appendix. Prognostic factors and evaluation of indications for right hemicolectomy.

BACKGROUND/AIMS: Carcinoidtumors of the appendix are thought to be the most common type of appendiceal neoplasms.

Although the vast majority of appendiceal carcinoids behave in a benign fashion, they are considered malignant because they all have the potential for invasion, metastasis and production of physiologically active substances.

RESULTS: The most common site for the tumors was the tip of the appendix (18/22).

In the rest of the cases, the neoplasms were located in the base (4/22) and in the body (2/22), while in one patient the mesoappendix was invaded.

In sixteen patients the tumor size was less than 1cm, in seven patients the tumor diameter was measured to be 1 to 2cm and in one patient the tumor was 3cm.

Most of our patients (16/22) underwent only an appendicectomy, while in the rest of them (in the patients with tumor size between 1-2cm and in the patient with invasion of mesoappendix) a right hemicolectomy was performed.

No patient was found to have metastatic disease during the operation, while the patient with invasion of the mesoappendix developed metastases in the lung, two years after the operation.

CONCLUSIONS: Carcinoidtumors of the appendix, in most cases, are found incidentally during appendicectomies, especially in young females and usually are less than 1cm in size, which is probably the reason of the absence of metastases in all cases.

Histological examination and size of the tumor are important factors that contribute to the selection of the surgical treatment and both must be estimated by the surgeons to make the final choice.

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(PMID = 15783011.001).

[ISSN] 0172-6390

[Journal-full-title] Hepato-gastroenterology

[ISO-abbreviation] Hepatogastroenterology

[Language] eng

[Publication-type] Journal Article

[Publication-country] Greece

38. Levy AD, Sobin LH: From the archives of the AFIP: Gastrointestinal carcinoids: imaging features with clinicopathologic comparison.Radiographics; 2007 Jan-Feb;27(1):237-57[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] From the archives of the AFIP: Gastrointestinal carcinoids: imaging features with clinicopathologic comparison.

Gastrointestinal carcinoids are well-differentiated endocrine neoplasms that belong to a diverse group of tumors that arise from cells of the diffuse endocrine system.

A wide variety of specialized endocrine cells that populate the gastrointestinal mucosa and submucosa give rise to carcinoids.

Consequently, carcinoids may occur throughout the gastrointestinal tract and produce a variety of hormones and protein products that are associated with specific clinical symptoms.

Biologic behavior of carcinoids varies by site and cell type, but all gastrointestinal carcinoids are considered to have malignant potential.

They may produce specific syndromes such as Zollinger-Ellison syndrome, or they may occur in association with inherited syndromes such as multiple endocrine neoplasia type 1 or neurofibromatosis type 1.

Metastatic carcinoids may produce carcinoidsyndrome.

The small intestine is the most common location for gastrointestinal carcinoids.

Most small intestinal carcinoids arise from enterochromaffin cells of the distal ileum that produce serotonin.

Small intestinal carcinoids often have an aggressive biologic behavior and, as such, patients frequently have metastases to regional lymph nodes and the liver at initial presentation.

Pathologic and radiologic manifestations of serotonin-producing small intestinal carcinoids are related to local and regional effects of serotonin and its metabolites.

In contrast, carcinoids of the appendix and rectum are commonly discovered incidentally as small lesions that are unassociated with clinical evidence of hormone production and have a more indolent clinical course.

Carcinoids of the stomach, duodenum, and colon are uncommon but have distinctive clinical, pathologic, and radiologic appearances.

Knowledge of the diverse clinical, pathologic, and radiologic spectrum of gastrointestinal carcinoids is important in the imaging and management of patients with suspected carcinoids or focal gastrointestinal masses.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PURPOSE: An individual with colorectal cancer has a 3 percent risk of synchronous colonic neoplasia and further 2 to 3 percent risk of metachronous cancer, a risk that has prompted colonic surveillance.

The appendix has a similar mucosal pattern to the colon and it has been hypothesized that appendicular adenocarcinoma may account for 1 percent of all colorectal malignancies.

A special interest of the senior author in appendiceal and rectal cancer has prompted routine removal of the appendix in all cases undergoing surgery for colorectal cancer.

RESULTS: In total, 169 patients under the care of a single surgeon had colorectal cancer resection between April 2002 and April 2005: 63 patients had right hemicolectomy, 29 had left hemicolectomy, and 77 had rectal cancer resection.

Metachronous neoplasia is a risk in the retained appendix in patients with colorectal cancer.

Routine postoperative surveillance cannot assess the appendiceal mucosa, so there is little justification for not taking the opportunity to eliminate the possibility of future appendicitis or neoplasia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Malignant neoplasms of the appendix.

BACKGROUND: Appendiceal neoplasms, first described in 1882, are still rare, with pre-operative diagnosis invariably difficult.

MATERIALS AND METHODS: A retrospective histopathological review of all appendicectomy specimens was completed between April 1994 and December 2003 to identify patients diagnosed with malignant neoplasms.

A literature search of the PubMed database was then performed using the medical search headings; appendix, tumour, neoplasm and malignancy.

RESULTS: Twenty-two patients (eight men) were identified during the study period, with no age difference between gender (mean age in women 58, range 14-83 vs mean age in men 55, range 16-78).

Eleven patients were found to have carcinoid-type tumours, eight patients with adenocarcinomas and three patients with lymphomas.

Other appendiceal pathologies were identified after appendicectomies, hemicolectomy and oophorectomy.

Patients with classical carcinoidtumours (CCT) had better outcomes than patients with the goblet cell carcinoid, adenocarcinoma and lymphoma.

CONCLUSIONS: From our own experience and a subsequent review of the literature, we recommend right hemicolectomy as the treatment of choice for all malignant appendiceal neoplasms, except for small CCT less than 2 cm in diameter at the tip of the appendix, with a low proliferative index, without angiolymphatic or mesoappendiceal extension.

Further adjuvant therapy should be considered after oncological assessment.

RESULTS: Appendicitis and abdominal mass were the major clinical manifestations.

The 1, 3, and 5-year survival rates of the primary appendix carcinoidtumor, mucinous tumor, and adenocarcinoma were 100.0%, 100.0%, and 91.7%, 100.0%, 86.7%, and 71.5%, and 75.0%, 50.0%, and 50.0% respectively.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Application of light microscopical and ultrastructural immunohistochemistry in the study of goblet cell carcinoid in the appendix.

BACKGROUND: Goblet cell carcinoids appear less frequently in the appendix than do other carcinoids.

In the presented work a case with a goblet cell carcinoid of the appendix is described.

METHODS: Routine histological and histochemical methods were employed, with a combination of histochemistry and immunohistochemistry on one section and light and electron microscopical immunohistochemisty on paraffin-embedded material, were applied to identify the type of the carcinoid and to reveal the fine structure of cell types in the tumour nests of the appendix.

RESULTS: During the biopsy of a patient who had undergone appendectomy, an infiltration with clusters of goblet cells in the submucosa of the appendix was found.

The ultrastructural immunohistochemistry showed that chromogranin A-positive cells had discoid and pleomorphic granules and were located in tumour nests or as single cells in the appendiceal wall.

CONCLUSION: The combined histochemical and immunohistochemical procedure and the ultrastructural immunohistochemistry on archival material could contribute in clarifying the diagnosis of goblet cell carcinoid.

Significant modifications concern carcinomas of the oesophagus, oesophagogastric junction, stomach, appendix, biliary tract, lung, skin, prostate and ophthalmic tumours, which will be not addressed in this article.

For several tumour entities only minor changes were introduced which might be of importance in daily practice.

The new classifications and changes will be commented on without going into details.

They are classified into two principal types: gastrointestinal ET's (formerly called carcinoidtumors) which are the most common, and pancreaticoduodenal ET's.

The management of ET is multidisciplinary.

Poorly-differentiated ET's have a poor prognosis and are treated by chemotherapy.

Surgical excision is the only curative treatment of well-differentiated ET's.

The surgical goals are to: 1. prolong survival by resecting the primary tumor and any nodal or hepatic metastases, 2. control the symptoms related to hormonal secretion, 3. prevent or treat local complications.

The most common sites of gastrointestinal ET's ( carcinoids) are the appendix and the rectum; these are often small (<1 cm), benign, and discovered fortuitously at the time of appendectomy or colonoscopic removal.

Ileal ET's, even if small, are malignant, frequently multiple, and complicated in 30-50% of cases by bowel obstruction, mesenteric invasion, or bleeding.

The carcinoidsyndrome (consisting of abdominal pain, flushing, diarrhea, hypertension, bronchospasm, and right sided cardiac vegetations) is caused by the hypersecretion of serotonin into the systemic circulation; it occurs in 10% of cases and is usually associated with hepatic metastases.

More than half of the cases of pancreatic ET are non-functional.

They are usually malignant and of advanced stage at diagnosis presenting as a palpable or obstructing mass or as liver metastases.

Insulinoma and gastrinoma (cause of the Zollinger-Ellison syndrome) are the most common functional ET's. 80% are sporadic; in these cases, tumor size, location, and malignant potential determine the type of resection which may vary from a simple enucleation to a formal pancreatectomy.

In 10-20% of cases, pancreaticoduodenal ET presents in the setting of multiple endocrine neoplasia (NEM type I), an autosomal-dominant genetic disease with multifocal endocrine involvement of the pituitary, parathyroid, pancreas, and adrenal glands.

For insulinoma with NEM-I, enucleation of lesions in the pancreatic head plus a caudal pancreatectomy is the most appropriate procedure.

For gastrinoma with NEM-I, the benefit of surgical resection for tumors less than 2-3 cm in size is not clear.

But the eventual development of liver metastases which are the most common cause of mortality still argues for an aggressive surgical approach in the early stages of the disease.

(PMID = 16142076.001).

[ISSN] 0021-7697

[Journal-full-title] Journal de chirurgie

[ISO-abbreviation] J Chir (Paris)

[Language] fre

[Publication-country] France

[Number-of-references] 236

47. May A, Nachbar L, Ell C: Push-and-pull enteroscopy using a single-balloon technique for difficult colonoscopy.Endoscopy; 2006 Apr;38(4):395-8[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PATIENTS AND METHODS: A push-and-pull enteroscopy device and a single-balloon technique was used in 14 patients (six men, eight women; mean age 62 +/- 15 years) after failure of ileocolonoscopy or endoscopic therapy using either a standard or a pediatric colonoscope.

The original ileocolonoscopy had been performed to investigate colon polyps (n = 6), an obscure inflammatory process in the ileocecal region (n = 6), or iron deficiency anemia with a positive fecal occult stool test (n = 2).

RESULTS: Ileocolonoscopy was successfully performed using this push-and-pull technique in all 14 patients without technical problems or complications.

Multiple polyps were found in six patients; a colon cancer was found in one patient; appendicitis combined with a carcinoidtumour of the appendix was diagnosed in one patient; ileocolitis was observed in two patients; one patient with Crohn's disease had stenoses in the region of an anastomosis; and in three patients no relevant pathological finding was seen.

CONCLUSION: It was possible to perform ileocolonoscopy with therapeutic interventions using this new thin push-and-pull enteroscopy device with a single-balloon technique in patients who had previously undergone incomplete colonoscopy using a standard colonoscope.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the Jejunum, Ileum, Appendix, and Cecum.

Well-differentiated neuroendocrine tumors (NETs) of the jejunum, ileum, and appendix are also collectively known as midgut carcinoids.

Classic carcinoidsyndrome is more likely to appear in patients with advanced disease.

With the exception of small well-differentiated NETs of the appendix, NETs of the midgut have substantial risk of relapse after resection and need to be followed for at least 7 years.Metastatic/advanced NETs of the midgut are incurable.

Somatostatin analogs are effective in the management of carcinoidsyndrome.

Octreotide long-acting release has also recently been shown to delay disease progression.

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(PMID = 20664473.001).

[ISSN] 1536-4828

[Journal-full-title] Pancreas

[ISO-abbreviation] Pancreas

[Language] eng

[Publication-country] United States

49. Terada T: Non-invasive Adenocarcinoma of the Vermiform Appendix: Incidence and Report of Four Cases among 512 Appendectomies.Gastroenterology Res; 2009 Aug;2(4):238-241[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Non-invasive Adenocarcinoma of the Vermiform Appendix: Incidence and Report of Four Cases among 512 Appendectomies.

: Tumors of the vermiform appendix are relatively rare.

More than 50% of appendiceal tumors are carcinoidtumors.

The author reviewed 512 consecutive pathological specimens of appendectomies in last ten years in our pathology laboratory in search for appendiceal tumors.

As the results, 4 cases (incidence: 0.8%) of non-invasive adenocarcinoma were found.

No other tumors includingcarcinoidtumors were recognized.

The results suggest that incidence of appendiceal adenocarcinoma was 0.8% of all appendectomies, and that non-invasive adenocarcinoma of the appendix shows variable morphologies, and that postoperative clinical outcome of non-invasive appendiceal tumor is good.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

RESULTS: The most often Crohn's disease were recognized (9 children), in 2 cases with concomitant other pathologies (fecal tumor ofappendix in one case and with peritoneal abscess after perforation of intestinal wall).

In one boy with ulcerative colitis, during exacerbation of the disease appendicitis complicated by rupture and peritonitis was observed.

Carcinoid of the appendix was the cause of abdominal pain in one child.

2. Despite new diagnostic imagines there are no definite criteria to recognize appendicitis, in most cases physical examination and very carefull evaluation of abdominal pain are the most important.

3. All children with periappendipected of Crohn's disease.

4. All children with equivocal presentations of appendicitis and with normal appendix during operation should undergo further diagnostic evaluation.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: IBD is a risk factor for development of colorectal neoplasia.

Although IBD frequently involves the appendix microscopically, it is uncertain whether it also predisposes to appendiceal neoplasia.

METHODS: We performed a retrospective case-control study of incidental appendiceal neoplasms in colectomy specimens of adults with and without IBD (cases and controls, respectively) based on surgical pathology records spanning 54 months.

To minimize referral bias, patients were excluded if they had preoperative clinical evidence or a principal pathologic diagnosis of appendiceal disease.

Elevated CgA transcript and protein levels indicative of acarcinoidtumor were identified in one acute appendicitis sample with no histologic evidence of a tumor.

CONCLUSIONS: These data demonstrate that malignant APCs and goblet cell adenocarcinoids have elevated expression of NAP1L1, MAGE-D2, and MTA1 compared with appendiceal carcinoids identified at surgery for appendicitis.

This and the differences in NALP1 gene expression (decreased in goblet cell adenocarcinoids) provide a series of molecular signatures that differentiate carcinoids of the appendix.

CgA identified all appendiceal tumors as well as covert lesions, which may be more prevalent than previously recognized.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Synchronous and metachronous ovarian and appendiceal mucinous tumors are often the subject of diagnostic consultations in gynecologic pathology practices to address whether the tumors are independent neoplasms or related as primary and metastasis.

The ovarian tumors were bilateral in 25 of 28 cases with data on both ovaries and were typically large (mean/median: 14 cm, range: 4.5 to 24.0 cm).

The appendices were often firm or thickened but usually did not have a discrete measurable tumor and were not notably enlarged; microscopically, transmural invasion was present in all of them.

The ovarian and appendiceal tumors exhibited a variety of patterns of differentiation, including signet ring cell and glandular, with all displaying some goblet cell carcinoidlike patterns (nests, islands, cords, or cryptlike tubules with goblet cells); teratomatous elements were not identified in any ovarian tumors.

Chromogranin was expressed in 7 of 19 ovarian tumors (mean/median: 6.3%/0%; range: 0% to 20%) and synaptophysin was expressed in 4 of 18 of these (mean/median: 7.8%/0%; range: 0% to 90%).

Chromogranin was expressed in 6 of 16 appendiceal tumors (mean/median: 11.9%/0%; range: 0% to 70%) and synaptophysin was expressed in 6 of 15 of these (mean/median: 16.7%/0%; range: 0% to 90%).

Follow-up was available for 25 patients: 17 died of disease at intervals ranging from 4 to 47 months (mean/median: 18/16) and 8 were alive with disease at 1 to 25 months (mean/median: 11/10); median survival was 19 months and the 1-year and 2-year survival rates were 63% and 34%, respectively.

The clinicopathologic features of these ovarian tumors indicate they should be labeled as metastatic appendiceal adenocarcinomas rather than as goblet cell carcinoidtumors both to reflect their behavior and help distinguish them from the rare true primary ovarian goblet cell carcinoidtumors.

As the ovarian tumors have appreciable components of signet ring cells they qualify as Krukenberg tumors.

In cases in which the primary tumor is not already evident, their "goblet cell carcinoidlike" patterns should direct attention to the appendix as a possible source.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

METHODS: We reviewed cases of 42 patients who underwent total laparoscopic hysterectomy or laparoscopic-assisted vaginal hysterectomy followed by appendectomy, performed by applying a stapler and removing the appendix transvaginally.

By using a small-diameter laparoscope, the appendix was mobilized, especially in patients with adhesions, endometriosis, or retrocecal appendix, to facilitate transvaginal access with the stapler.

RESULTS: All procedures were performed successfully without intraoperative or major postoperative complications.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The immunoexpression of CK19 recently has been identified as a marker of poor prognosis in pancreatic endocrine tumors and hepatocellular carcinoma.

The purpose of this study was to explore CK19 and CD99 immunostaining in mucin-producing neuroendocrine (goblet cell) and classical carcinoids of the appendix.

Eighteen goblet cell carcinoids (GCCs) and 20 classic carcinoids were stained with CK19, CD99, and Ki-67, and these results were correlated with known pathological features of aggression: extent of invasion, mitoses, necrosis, and histological pattern.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Adenocarcinoid tumor of the extrahepatic biliary tract.

The term adenocarcinoid was first coined by Warkel et al in 1978 to describe a group of uncommon low-grade malignant appendiceal tumors with morphologic and histochemical evidence of both glandular (adenocarcinoma) and neuroendocrine (carcinoid) differentiation for which several terms have been used in the past.

Although the appendix is the most frequent site of this tumor, similar neoplasms have been reported also in other sites, such as colon, gallbladder, Vater's ampulla, and stomach.

Provided that it can metastasize, a recent meta-analysis on appendiceal adenocarcinoids showed that right hemicolectomy is not required when the tumor is completely excised and there is no cecal involvement.

In this article, the clinicopathologic features of an adenocarcinoid tumor occurring in the extrahepatic biliary tract with infiltration of the common hepatic duct wall that, to the best of our knowledge, represents the first report in this site is described.

[Publication-country] United States

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoidtumors.

Carcinoidtumors are rare, slow-growing neuroendocrine neoplasms that often are indolent and may not become clinically apparent until there has been metastatic spread or evidence of carcinoidsyndrome.

Recent evidence has revealed that the overall incidence of carcinoidtumors has been steadily increasing, and although the disease was thought to be relatively benign, it is now considered one of increasing malignancy.

Carcinoidtumors derive from different embryonic divisions of the gut: foregut carcinoidtumors commonly originate in the lungs, bronchi, or stomach; midgut carcinoidtumors in the small intestine, appendix, or proximal large bowel; and hindgut carcinoidtumors in the distal colon or rectum.

Carcinoidsyndrome, although rare, is most associated with midgut carcinoidtumors.

The diagnosis of acarcinoidtumor often is coincidental with surgery performed for another reason.

Treatment and prognosis are dependent on the location of the primary tumor and the degree and extent of metastasis at the time of diagnosis.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Goblet cell carcinoidtumors of the appendix: An overview.

Goblet cell carcinoid is an enigmatic and rare tumor involving the appendix almost exclusively.

Since its identification in 1969, understanding of this disease has evolved greatly, but issues regarding its histogenesis, nomenclature and management are still conjectural.

Various other names have been used for this entity such as adenocarcinoid, mucinous carcinoid, crypt cell carcinoma, and mucin-producing neuroendocrine tumor, although none have been found to be completely satisfactory or universally accepted.

The tumor is thought to arise from pluripotent intestinal epithelial crypt-base stem cells by dual neuroendocrine and mucinous differentiation.

The most common clinical presentation is acute appendicitis, followed by abdominal pain and a mass.

The histologic hallmark of this entity is the presence of clusters of goblet cells in the lamina propria or submucosa stain for various neuroendocrine markers, though the intensity is often patchy.

Atypia is usually minimal, but carcinomatous growth patterns may be seen.

These may be of signet ring cell type or poorly differentiated adenocarcinoma.

Recently molecular studies have shown these tumors to lack the signatures of adenocarcinoma but they have some changes similar to that of ileal carcinoids (allelic loss of chromosome 11q, 16q and 18q).

The natural history of GCC is intermediate between carcinoids and adenocarcinomas of the appendix.

The most important prognostic factor is the stage of disease.

There is some debate about the surgical approach for these tumors, and a summary of published series and recommendations are provided.

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Three patients had no residual or recurrent carcinoidtumor on EUS examination after previous empiric polypectomy or biopsy.

Five patients had suspected rectal myogenic stromal tumors on EUS; three were transferred for surgical resection due to uterine myoma compression (N = 2) or mucinous adenocarcinoma of the appendix with rectal metastasis (N = 1), and two had uterine myoma detected by gynecologic ultrasound or CT.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Diverticular disease of the vermiform appendix: a diagnostic clue to underlying appendicealneoplasm.

Acquired diverticula of the vermiform appendix are rare and arise as a result of different pathogenetic mechanisms.

One of the etiologies includes proximally located, often unsuspected small neoplasms.

Although the association of appendiceal diverticulosis and neoplasia is known, it remains underemphasized in the teaching and practice of surgical pathology.

To investigate the frequency of appendiceal neoplasms with acquired diverticulosis, we conducted a retrospective analysis of all appendectomy specimens received in our institution for a 55-month period (January 2002-July 2006).

Eleven (48%) appendectomy specimens with diverticulosis also harbored an appendicealneoplasm.

1. 2010 we followed up 50 pts (19 men/31 women) with well differentiated GEP neuroendocrine tumors.

Metastatic disease was affirmed in time of diagnosis in 36 patients.

Carcinoid syndroma had 20 pts, 4 pts with pancreatic tumor had functional tumors (2 times overproduction of calcitonine, 1 times of gastrin, 1 times of insuline).

Surgical treatment was performed in 40 pts--resection of primary tumor and debulking of metastases, in 5 pts with pancreatic tumor resection was not possible due to invasion to sorrounding tissue and vessels.

Biological treatment with long acting somatostatin analogues was indicated in 20 pts with carcinoid syndroma and in 4 pts with functional pancreatic tumors.

In 5 pts with non resectable neuroendocrine carcinoma of pancreas peptid radionuclide receptor therapy (PRRT) was indicated: in 4 of them with 90Ytrium-DOTA-octreotid and in 1 patient with MIBG.

In all pts a reduction of tumor volume was noticed.

Biotherapy with somatostatin analogues reduced symptoms of hormonal activities and brought on stabilisation of disease in most of patients.

CONCLUSION: Complex therapy in patients with well differentiated neuroendocrine tumors markedly contributes to prolongation of survival of patients and also to enhancement quality of their life.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoidtumor of the appendix in childhood: the experience of two Italian institutions.

OBJECTIVES: Although rare, carcinoidtumor of the appendix is the most common neoplasm of the gastrointestinal tract in children and adolescents.

It is usually an incidental finding after a laparotomy for appendectomy, with a frequency of 2 to 5 cases per 1000 appendectomies.

The experience with 14 cases of carcinoid reported in the appendix is described.

METHODS AND RESULTS: In six patients the tumor measured 1 cm or less; only in one patient did it measure 2 cm.

In three patients the tumor measured between 1 and 2 cm and in four the size was not known.

All tumors were discovered by chance, and three patients underwent further surgery as a result of suspected involvement of the margins.

All the patients were alive with no evidence of disease at 24 to 214 months from diagnosis.

In our experience, both patients with local invasiveness and the patient with a tumor larger than 2 cm had good outcomes.

Ileocolectomy performed in the patient with a 2-cm tumor and in another two patients with smaller tumors did not demonstrate residual disease.

Although the need for right hemicolectomy still remains controversial for tumors measuring more than 2 cm, the approach may be nonaggressive in case of tumors invading the serosa and the periappendiceal fat.

Nonaggressive treatment has been suggested by some authors in cases of tumors larger than 2 cm; however, larger series need to be evaluated.

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(PMID = 15699700.001).

[ISSN] 0277-2116

[ISO-abbreviation] J. Pediatr. Gastroenterol. Nutr.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

73. Kaya M, Kanmaz T, Boleken ME, Yücesan S: Appendix carcinoid found incidentally during excision of a choledochal cyst: report of a case.Surg Today; 2005;35(5):418-20[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Appendix carcinoid found incidentally during excision of a choledochal cyst: report of a case.

We report the case of a 13-year-old girl in whom an appendix carcinoid was found incidentally during excision of a choledochal cyst.

Although incidental carcinoidtumors of the extrahepatic bile ducts have been reported, to the best of our knowledge this is the first published case of a choledochal cyst associated with an appendix carcinoid.

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(PMID = 15864427.001).

[ISSN] 0941-1291

[Journal-full-title] Surgery today

[ISO-abbreviation] Surg. Today

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Japan

74. Soga J: Carcinoids of the pancreas: an analysis of 156 cases.Cancer; 2005 Sep 15;104(6):1180-7[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoids of the pancreas: an analysis of 156 cases.

BACKGROUND: The aim of the current study was to clarify the actual clinicopathologic status of extremely rare pancreatic carcinoids.

To date, statistical evaluation of such carcinoids has been hampered because an insufficient number of cases has prevented any reliable statistical analyses.

METHODS: The Niigata Registry for Gut-Pancreatic Endocrinomas contains a total number of 156 cases of pancreatic carcinoids among 165 endocrinocarcinomas registered worldwide.

This figure of 156 cases comprises 144 typical and 12 atypical carcinoids, which were compared statistically with carcinoids in other representative sites, according to various clinicopathologic criteria.

RESULTS: Pancreatic carcinoids made up 1.4% of the total number of registered cases (n = 11,343) and were characteristic in the following five ways.

2) They displayed the largest average tumor size (68.6 mm), followed by that for the ovary (68.2 mm), and ileocecum (46.5 mm) against a total average of 30.2 mm.

3) They revealed a relatively high incidence of the carcinoidsyndrome (23.3%), almost equal to that for the ileocecum (24.1%), and exceeded by that for the small intestine (35.8%), when compared with that for the total average of 11.0%.

5) Five-year survival rate was extremely low (28.9% +/- 16.7%) compared with those for the appendix (89.7% +/- 2.0%) and the small intestine (82.1% +/- 3.3%).

It was noteworthy that silver impregnations in the pancreatic carcinoid series indicated a result identical to that for the total average: Grimelius argyrophilia, 84.8% versus 85.4%; argyrophil cell type, 59.1% versus 58.5%; and argentaffin cell type, 22.7% versus 22.3%.

CONCLUSION: It may be said that in the treatment of patients with pancreatic carcinoids, appropriate procedures should be carried out with these distinguishing characteristics always kept in mind.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Tachykinins in endocrine tumors and the carcinoidsyndrome.

OBJECTIVE: A new antibody, active against the common tachykinin (TK) C-terminal, was used to study TK expression in patients with endocrine tumors and a possible association between plasma-TK levels and symptoms of diarrhea and flush in patients with metastasizing ileocecal serotonin-producing carcinoidtumors (MSPCs).

METHOD: TK, serotonin and chromogranin A (CgA) immunoreactivity (IR) was studied by immunohistochemistry in tissue samples from 33 midgut carcinoids and 72 other endocrine tumors.

Circulating TK (P-TK) and urinary-5 hydroxyindoleacetic acid (U-5HIAA) concentrations were measured in 42 patients with MSPCs before treatment and related to symptoms in patients with the carcinoidsyndrome.

RESULTS: All MSPCs displayed serotonin and strong TK expression.

TK-IR was also seen in all serotonin-producing lung and appendixcarcinoids.

None of the other tumors examined contained TK-IR cells.

Concentrations of P-TK, P-CgA, and U-5HIAA were elevated in patients experiencing daily episodes of either flush or diarrhea, when compared with patients experiencing occasional or none of these symptoms.

In a Spearman partial rank test, the correlation of P-TK with daily diarrhea was independent of both U-5HIAA and CgA levels.

CONCLUSION: We found that TK synthesis occurs in serotonin-IR tumors and that P-TK levels are significantly correlated with symptoms of flush and diarrhea in patients with MSPCs.

This is, to our knowledge, the first report demonstrating an independent correlation of P-TKs with carcinoid diarrhea, a symptom that is customarily regarded as serotonin mediated.

Further investigations may present opportunities for new therapeutic possibilities.

In this report, we describe 5 cases of combined classical carcinoid and goblet cell carcinoid (GCC) tumors of the appendix.

The tumors (0.6 to 6.0 cm) were located in the mid-portion and the tip of the appendix.

Four patients are alive and asymptomatic, whereas the patient with disseminated pelvic disease died 6 months after surgery.

All 5 appendiceal tumors had microscopic features of both classical carcinoid and GCC, either intimately admixed or separate but closely apposed.

The extent of the 2 components varied, with classical carcinoid representing 60% to 90% of the tumor.

Both components stained for the general neuroendocrine markers, however, staining in the classic component was greater.

The pelvic soft tissue and ovarian metastases in case 4 consisted predominantly of a signet ring cell carcinoma with a minor component of goblet cells and was interpreted as an adenocarcinoma ex-GCC.

In view of the fact that these combined carcinoidtumors appear to behave more as goblet cell carcinoids, detailed microscopic examination of classical carcinoidtumors of the appendix is suggested and larger series with longer follow-up is required to ascertain the true biologic potential of this unique form of combined carcinoidtumor of the appendix.

The occurrence of both carcinoid types in the same appendices suggests a closer histogenetic relationship than previously believed, although the possibility that the 2 components represent separate, independent primaries ("collision tumors") can also be considered.

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(PMID = 20631606.001).

[ISSN] 1532-0979

[Journal-full-title] The American journal of surgical pathology

[ISO-abbreviation] Am. J. Surg. Pathol.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Biomarkers, Tumor

79. Pahlavan PS, Kanthan R: The epidemiology and clinical findings of colorectal cancer in Iran.J Gastrointestin Liver Dis; 2006 Mar;15(1):15-9[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The epidemiology and clinical findings of colorectal cancer in Iran.

[Publication-country] United States

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Goblet cell carcinoid of the appendix.

BACKGROUND: Goblet cell carcinoid (GCC) of the appendix is a rare neoplasm that share histological features of both adenocarcinoma and carcinoidtumor.

While its malignant potential remains unclear, GCC's are more aggressive than conventional carcinoid.

The clinical presentations of this neoplasm are also varied.

This review summarizes the published literature on GCC of the appendix.

METHODS: Published studies in the English language between 1966 to 2004 were identified through Medline keyword search utilizing terms "goblet cell carcinoid," "adenocarcinoid", "mucinous carcinoid" and "crypt cell carcinoma" of the appendix.

RESULTS: Based on the review of 57 published papers encompassing nearly 600 diagnosed patients, the mean age of presentation for GCC of the appendix was 58.89 years with equal representation in both males and females.

Accurate diagnosis of this neoplasm requires astute observations within an acutely inflamed appendix as this neoplasm has a prominent pattern of submucosal growth and usually lacks the formation of a well-defined tumor mass.

The most common clinical presentations in order of frequency were acute appendicitis in 22.5%; asymptomatic in 5.4%; non-localized abdominal pain in 5.15% and an appendicular mass in 3.09%.

GCC's of the appendix remains a neoplasm of unpredictable biological behavior and thus warrants lifelong surveillance for recurrence of the disease upon diagnosis and successful surgical extirpation.

CONCLUSION: GCC of the appendix is a rare neoplasm.

Due to its wide range of presentation, this tumor should be considered as a possible diagnosis in many varied situations leading to abdominal surgery.

The advocated plan of management recommended for patients with tumors that involve the adjacent caecum or with high-grade tumors with histological features such as an increased mitotic rate involve initial appendectomy with completion right hemicolectomy due to the high possibility of local recurrence with intraperitoneal seeding prior to lymph node involvement and a 20% risk of metastatic behavior.

In female patients with GCC of the appendix regardless of age, bilateral salpingo-oophorectomy is advocated.

In cases with obvious spread of the disease chemotherapy, mostly with 5-FU and leucovorin is advised.

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(PMID = 16253897.001).

[ISSN] 1521-6918

[ISO-abbreviation] Best Pract Res Clin Gastroenterol

[Language] eng

[Publication-type] Comparative Study; Journal Article; Review

[Publication-country] England

[Number-of-references] 32

84. Hsu TC: Intra-abdominal lesions could be missed by inadequate laparoscopy.Am Surg; 2008 Sep;74(9):824-6; discussion 827-8[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

This study is a retrospective analysis of a single surgeon's experience of the frequencies of unexpected findings during laparotomies.

Eleven patients were found to have synchronous colorectal cancers; five patients were found to have unexpected liver metastases; three patients each were found to have gastric cancers, stromal tumors of the small bowel, and ectopic pancreas; two patients each were found to have gastric leiomyosarcomas, pancreatic cancers, mucoceles of the appendix, ulcers of the small intestine, bleeding Meckel's diverticula, pancreatitis, and perforations of the ileum; one patient each was found to have gall bladder cancer, malignantcarcinoidtumor, pheochromocytoma, diverticulitis of the jejunum, diverticulitis of the colon, duplication of the colon, and aortic aneurysm larger than 6 cm.

Overall survival was 68.7 per cent and mortality rate was 19.5 per cent from carcinoidtumors.

Most of the deaths occurred in patients with carcinoidsyndrome, synchronous malignancy, and malignantcarcinoidtumors.

Screening colonoscopy, in addition to decreasing colorectal adenocarcinoma mortality, is useful in diagnosing carcinoidtumors at an earlier stage and in decreasing mortality from malignant colorectal carcinoidtumors.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The name ''carcinoid'' was invented by Oberndorfer in 1907, when the nature of those histological entities was little understood.

Usually, they were found in various locations in the gastrointestinal (GI) apparatus (67%), most of them in the small intestine (25%), appendix (12%), and rectum (14%).The techniques used for their removal are various.

The authors present here a case of rectal carcinoid removed using the transanal endoscopic microsurgery technique, and referred to the diagnosis and treatment of this uncommon tumor.

The histological finding demonstrated a nodule characterized by cellular proliferation, with few microscopical abnormalities, arranged in small cords with a glandular pattern, separated by dense connective tissue.

Careful attention must be paid to these tumors because of their unexpected behaviour.

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(PMID = 18607329.001).

[ISSN] 0026-4733

[Journal-full-title] Minerva chirurgica

[ISO-abbreviation] Minerva Chir

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Italy

89. Bertuzzo VR, Coccolini F, Pinna AD: Peritoneal seeding from appendiceal carcinoma: A case report and review of the literature.World J Gastrointest Surg; 2010 Aug 27;2(8):265-9[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Peritoneal seeding from appendiceal carcinoma: A case report and review of the literature.

Non-carcinoidappendiceal malignancies are rare entities, representing less than 0.5% of all gastrointestinal malignancies.

Because of their rarity and particular biological behavior, a substantial number of patients affected by these neoplasms do not receive appropriate surgical resection.

In this report, we describe a rare case of primary signet-ring cell carcinoma of the appendix with peritoneal seeding which occurred in a 40-year old man admitted at the Emergency Surgery Department with the clinical suspicion of acute appendicitis.

This report offers a brief review of the literature and suggests an algorithm for the management of non-carcinoidappendiceal tumors with peritoneal dissemination.

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RECENT FINDINGS: Thyroid nodules are uncommon but malignant in as many as 27% of patients.

Adrenal neoplasms cover a wide spectrum of disorder.

Carcinoids are rare neuroendocrine neoplasms, primarily of the appendix, associated with carcinoidsyndrome in 10% of patients.

SUMMARY: Endocrine neoplasms are unusual in the pediatric population.

Their presence should raise concern about a multiple endocrine neoplasia syndrome and appropriate diagnostic and endocrine work-up.

Most neoplasms will require surgical resection.

[MeSH-major] Endocrine Gland Neoplasms

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(PMID = 19421059.001).

[ISSN] 1531-698X

[Journal-full-title] Current opinion in pediatrics

[ISO-abbreviation] Curr. Opin. Pediatr.

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] United States

[Number-of-references] 75

91. Louthan O: [Neuroendocrine tumours of the appendix].Vnitr Lek; 2009 Nov;55(11):1051-5[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The objective of the present study was to quantitate these discordant histopathological findings and examine its clinical implication.

All resected specimens were individually submitted for histopathological examination and immunostaining with three neuroendocrine markers.

The loss of the neuroendocrine tumor type in peritoneal implants was referred to as discordant feature of the adenocarcinoid tumor.

RESULTS: In nine of the 26 patients (35%) with a primary adenocarcinoid of the appendix, a loss of the neuroendocrine immunochemical marker was noted in peritoneal implants.

Discordant histology between the primary appendiceal adenocarcinoid and the peritoneal implants was statistically significantly associated with an improved survival (p = 0.0262), when patients were treated by cytoreductive surgery and perioperative intraperitoneal chemotherapy.

CONCLUSIONS: Discordant histology of the primary appendiceal tumor as compared to the peritoneal lesions occurs frequently in patients with adenocarcinoid.

An assessment of neuroendocrine markers in both primary and peritoneal lesions may help in the clinical assessment of this group of patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Carcinoidtumors originate from the argentofile cells found at the bottom of the crypt of Lieberkuhn.

In spite of their slow growth and comparatively better prognosis, the carcinoid are malignant tumors, which effective treatment is their surgical resection.

We present 10 patients with carcinoid of the gastrointestinal tract (GIT)--3 from small intestine, 3 from large intestine, 2 from appendix, I from rectum and 1 from stomach, operated at our clinic for a 6 year period of time.

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(PMID = 18693512.001).

[ISSN] 0450-2167

[Journal-full-title] Khirurgii︠a︡

[ISO-abbreviation] Khirurgiia (Sofiia)

[Language] bul

[Publication-type] English Abstract; Journal Article

[Publication-country] Bulgaria

99. Chung TP, Hunt SR: Carcinoid and neuroendocrine tumors of the colon and rectum.Clin Colon Rectal Surg; 2006 May;19(2):45-8[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Carcinoidand neuroendocrine tumors of the colon and rectum.

Carcinoidand neuroendocrine tumors of the colon and rectum arise from the amine precursor uptake and decarboxylation (APUD) cells of the intestine.

Carcinoidtumors are most commonly found in the gastrointestinal tract and are located in decreasing order of frequency in appendix, ileum, rectum, stomach, and colon.

The management of these lesions depends upon the size of the lesion, involvement of the muscularis, location, and presence of metastatic disease.

Adjuvant therapy is indicated only for metastatic disease, and admirable advances have been made in the realm of chemotherapy for reduction of disease and palliation of the symptoms of carcinoidsyndrome.

In this article, we discuss the nature of these interesting and uncommon tumors, clinical presentation, treatment options, and prognosis.

(PMID = 20011309.001).

[ISSN] 1530-9681

[Journal-full-title] Clinics in colon and rectal surgery

[ISO-abbreviation] Clin Colon Rectal Surg

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Other-IDs] NLM/ PMC2780103

[Keywords] NOTNLM ; Carcinoid / colon / neuroendocrine tumor / rectum

100. Mukensnabl P, Michal M, Hadravská S: [Carcinoids of the appendix].Rozhl Chir; 2005 Apr;84(4):197-200[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Carcinoids of the appendix].

[Transliterated title] Karcinoidy apendixu.

The appendical carcinoids represent a heterogeneous group of tumors of different morphology, biological features and treatment.

Our study aims to inform clinical practitioners, mainly surgeons and oncologists, about individual types of the appendical carcinoids, which are considered the most frequent carcinoidtumors the clinical practitioners come into contact with at all levels of the hospital care.

Our work describes the types of the appendical tumors from the histological point of view, as well as from the prognostic and therapeutical points of view.

At the end of the study report, a brief table summarizing the most important features of the individual histological types of the appendical carcinoids, is attached.